go back

Physical Therapy Evaluation, High Complexity

New Hampshire rates for HCPCS 97163

A physical therapist assesses a person's movement, strength, and physical function to understand how an injury or condition is limiting them, then develops a plan of care. This version applies to more complicated cases, involving a more extensive health history and a higher number of factors affecting movement and function than a simpler evaluation.

Rates data updated October 2026.

How much does Physical Therapy Evaluation, High Complexity cost?

$87.10

Typical physician fee. In New Hampshire, October 2026.

Insurers have agreed to pay about $87.10 for this service. Most negotiated rates run $81.28 to $107.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $63 · 10th to 90th $63 to $148Professionalmedian $87 · 10th to 90th $63 to $141
$100$200facility $63professional $87

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$63.10
Median
$63.10
Typical High
$147.91
Aetna
Setting
Professional
Modifier
None
Typical Low
$63.10
Median
$63.10
Typical High
$83.18
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$31.62
Median
$31.62
Typical High
$31.62
Anthem BCBS
Setting
Professional
Modifier
None
Typical Low
$87.10
Median
$87.10
Typical High
$102.33
Cigna
Setting
Facility
Modifier
None
Typical Low
$128.82
Median
$128.82
Typical High
$128.82
Cigna
Setting
Professional
Modifier
None
Typical Low
$70.79
Median
$95.50
Typical High
$199.53
Harvard Pilgrim
Setting
Professional
Modifier
None
Typical Low
$89.13
Median
$107.15
Typical High
$208.93
United
Setting
Professional
Modifier
None
Typical Low
$74.13
Median
$89.13
Typical High
$128.82
Well Sense
Setting
Professional
Modifier
None
Typical Low
$53.70
Median
$53.70
Typical High
$53.70
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Ambetter
Setting
Professional
Modifier
GP · Physical therapy plan
Typical Low
$79.43
Median
$79.43
Typical High
$79.43

Where New Hampshire sits

The same service costs 3.3 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Hampshire· 24th of 51

$87.10

AK $200FL $60.26

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.